双极射频消融联合心理治疗对风湿性心脏病患者的效果  

Effect of bipolar radiofrequency ablation combined with psychotherapy in patients with rheumatic heart disease

作　　者：李建强 谷腾飞 赵子牛 LI Jianqiang;GU Tengfei;ZHAO Ziniu(Department of Cardiovascular Surgery,Fuwai Huazhong Cardiovascular Hospital,Zhengzhou 450000,China)

机构地区：[1]阜外华中心血管病医院(河南省人民医院心脏中心)心血管外科,郑州450000

出　　处：《国际精神病学杂志》2022年第3期530-533,共4页Journal Of International Psychiatry

基　　金：河南省医学科技攻关计划联合共建项目(编号:2018020457)。

摘　　要：目的观察双极射频消融联合心理治疗对风湿性心脏病(Rheumatic heart disease,RHD)合并心房颤动(Atrial fibrillation,AF)患者的效果及对其抑郁,焦虑情绪的影响。方法选择2019年1月~2020年12月接诊的150例RHD合并AF患者,随机分为:观察组(纳入75例,行双极射频消融+心理治疗),对照组(纳入75例,行双极射频消融),比较两组间的超声功能参数,抑郁及焦虑评分,术中指标,房颤消除率,健康调查简表(SF-36)。结果(1)术后6个月,观察组超声功能参数,抑郁及焦虑评分,SF-36评分优于对照组(P<0.05);(2)观察组转流时间(127.64±27.58)min,主动脉阻断时间(69.14±12.48)min均少于对照组(158.57±34.85)min,(75.23±17.54)min(P<0.05);(3)观察组术后1,3,6个月时的房颤消除率均高于对照组(P<0.05)。结论对RHD合并AF患者行双极射频消融联合心理治疗,可以提高房颤消除率,改善心功能,恢复正常窦性心律,减轻抑郁,焦虑情绪,提高生活质量。Objective To observe the effect of bipolar radiofrequency ablation combined with psychotherapy on patients with rheumatic heart disease(RHD)complicated with atrial fibrillation(AF)and its influence on their depression and anxiety.Methods 150 patients with RHD complicated with AF admitted from January 2019 to December 2020 were randomly divided into observation group(75 cases were included and underwent bipolar radiofrequency ablation+psychotherapy)and control group(75 cases were included and underwent bipolar radiofrequency ablation).The ultrasonic functional parameters,depression and anxiety scores,intraoperative indexes,atrial fibrillation elimination rate and health survey summary(SF-36)were compared between two groups.Results(1)Six months after operation,the ultrasonic functional parameters,depression and anxiety scores and SF-36 scores in the observation group were better than those in the control group(P<0.05).(2)The shunt time(127.64±27.58)min and aortic occlusion time(69.14±12.48)min in the observation group were less than those in the control group(158.57±34.85)min and(75.23±17.54)min,P<0.05.(3)The elimination rate of atrial fibrillation in the observation group at 1,3 and 6 months after operation was higher than that in the control group(P<0.05).Conclusion Bipolar radiofrequency ablation combined with psychotherapy in patients with RHD complicated with AF can improve their elimination rate of atrial fibrillation,improve their cardiac function,restore normal sinus rhythm,reduce their depression and anxiety,and improve their quality of life.

关 键 词：双极射频消融 心理治疗 风湿性心脏病 心房颤动 抑郁焦虑分 

分 类 号：R749.055[医药卫生—神经病学与精神病学]